HJNO Jul/Aug 2026

HEALTHCARE JOURNAL OF NEW ORLEANS I  JUL / AUG 2026 9 Bruce Greenstein has spent the last 30 years in healthcare, split between the public and private sectors. He ran strategy and innovation at the nation’s largest post-acute care company. He was the chief technology officer at the U.S. Department of Health & Human Services during President Trump’s first administration, secretary for the Louisiana Department of Health under the Jindal administration, and led Microsoft’s worldwide health and human services business division. Prior to Microsoft, he worked at CMS overseeing Medicaid Managed Care and Waivers & Demonstrations. Additionally, he has been an advisor to the health informatics programs at George Washington University and the University of Louisiana at Lafayette. Secretary Bruce Greenstein Louisiana Department of Health Dianne Hartley, Editor Thank you for being with us today. You’ve seen Louisiana healthcare over a long arc — through different governors, different Medicaid models, different federal policies, and different public health priorities. Are Louisianans healthier than they were 20 years ago? Where has the state made real progress, and where is it still failing? Secretary Bruce Greenstein All right. Well, let me start by saying that we’re in a much better place today than we were 20 years ago. As a state, our access to care, both primary care and specialty care, has never been as good as it is today, yet we still have a long way to go for our health outcomes to be amongst the national leaders. We see a lot of heterogeneity in our rankings. Many people like to point out that we rank 50th in America’s Health Rankings, which is a composite index, but when you look deeper into it, you see that our rates for cancer screenings are quite good. Our health systems ranking is good. Our access to care is good. We are still challenged by certain behav- iors like smoking, for example, and the rate of chronic disease burden that we shoul- der, and that’s what we’re focused on right now. I think we should claim victory in using our policy levers to make healthcare more abundant and accessible to all Louisian- ians, and now we’re focused on improving the health rankings through people’s actual health outcomes. I should also say over the last 20 years, we continue to aim at moving targets. Twenty years ago there wasn’t an opioid crisis as there is today. And as we focused on try- ing to address overdoses, we’ve had quite a bit of success. Last year, we reduced drug overdose deaths by 31%. We have over 25,000 opioid overdose reversals by nal- oxone alone, and we continue to climb in our opioid overdose death rankings. It’s get- ting better and better. We were concerned about behavioral health 20 years ago, but drug overdose deaths were not nearly at the same level as it is today. So while we con- tinue to focus on our core sets of outcomes, we are constantly monitoring changes in healthcare and responding appropriately. Editor What attracted you to healthcare, and how did the conversation go when you were asked to return as secretary? Greenstein Well, it’s a long, long story about how I got into healthcare. I thought I was on my way to medical school when I was in college, but turns out I was way better at mathematics than I was at organic chemistry. I ended up as an economist and working on policy instead, and I just fell in love with policy after working for state governments, federal governments, publicly traded companies, and startups. I continued to keep my entire life in the healthcare world. Coming back to Louisiana to be Secre- tary of Health, it’s just simply the best job in ONE on ONE